Think Outside the Box

by Benjamin King 26. March 2013 11:24
Everyone’s talking about Meaningful Use Stage 2. But if you know much about Voalte, you know we don’t just go along with what everyone else is doing.

In fact, four years ago Voalte was first to introduce iPhones at the point of care, and hospital nurses were using Voalte One before EMR companies even started building apps for mobile use. Our solution improves communication so effectively, we’re working with third parties to incorporate our technology into their systems.

Now, when everyone else is focused on Stage 2, we’re already working on Stage 3 initiatives … and beyond.

So far, nurses at acute care hospitals have benefitted most from Voalte solutions. That will change as we expand our services to clinical departments such as pharmacy and radiology, physicians working inside and outside the hospital, and other healthcare workers. In other words, everyone involved throughout the entire “continuum of care.” 

Too often, hospitals function as an assembly line, with sick patients going in one door and healthy people coming out another. Treatment takes place within the confined box of the hospital. The problem is, too many people end up back where they started, with some studies showing 1 in 5 patients being readmitted within a month.

What if we re-invent the impersonal process of leaving the hospital, when most patients are too groggy to fully understand a doctor’s orders? What if a nurse could tell a patient: “Download this app, then go home and get some rest. We will contact you in 24 hours to answer any questions and make sure you’ve taken your medicine.” 

Follow-up communication like this won’t be cost-prohibitive for the hospital, and could boost patient satisfaction scores as well.

When we started Voalte, we focused on introducing smartphones into the point of care. In the next couple of years, we will be growing beyond the bedside, outside the hospital, and even into patients’ homes. With Stage 3 requirements expected to take effect in 2016, the innovative solutions we’re thinking about today will create meaningful results in the future.

Illustration by Miguel Elasmar

Will your web browser become your next telephone?

by Benjamin King 29. November 2012 08:30
Untitled Document

WebRTCVery soon your web browser will become your next telephone!  Surprised.  You should be.  Soon you will be able to make voice and even video calls to anyone running the latest web browser.  No apps to download, no installs and no sign ups.  It’s just you and your web browser.

WebRTC is a free, open project that enables Real-Time Communication (RTC) capabilities to be built right into the web browser without any extra plug-ins or software.  In addition to voice and video calls, it will also be possible to screen share and transfer files. 

What does this mean for you?
Websites will become more interactive “environments” where other users will be able to interact and communicate in real-time, rather than static pages of text and images.  It will also allow for imagine browsing on an online store, being able to chat with other shoppers or even talk with a salesperson or customer support directly and immediately.

What does this mean for healthcare?
This will make telemedicine easier and cheaper to achieve because it won’t require any special hardware or software to setup a videoconference between a patient and a healthcare provider.  It could also change the landscape of medical devices, for example, a nurse could receive a critical alarm that links to the patient monitoring device showing the live waveform or real-time values like heart rate.

What browsers have it? 
WebRTC is not generally available in any web browser yet, but you can try it in early experimental versions of Google Chrome, Mozilla Firefox or Opera.

When will it be generally available? 
I guesstimate that 2013 will be the year of WebRTC and it should be available on all major web browsers.

I am very excited about this new technology because it will take web browsers and communication to the next level.  Telecommunications started with landline telephones that only made voice calls, then wireless smartphones enabled voice, video and data and now the web browser will have the ability to allow easy real-time collaboration between individuals and offer direct access to real-time data.

Is the Race On?

by Benjamin King 18. July 2012 18:52

The other day I had a chance to use Apple’s new Macbook Pro with Retina display and I was completely amazed—make that blown away! Trust me, I’m not easily impressed and I had a hard time believing it was the “best Mac Apple has ever built” according to one review from a well-respected computer hardware blog. But I stand corrected and completely agree--everything from text to photos to HD videos looked so much better and sharper. I immediately thought what would an MRI or CT scan look like on this display?

What is a retina display? Retina display is a brand name used by Apple for displays Apple claims to have a high enough pixel density that the human eye is unable to notice pixelation at a typical viewing distance. For a comparison, see the table below, comparing the resolution of a DVD, HDTV and the Retina display. Notice that the 15” Macbook retina display has 15 times more pixels then a DVD and 2.5 times more than a HDTV. Now that’s pretty impressive.

  DVD  1080p HDTV  15" Macbook Pro Retina 
 Resolution 720x480 1920x1080 2880x1800 
 Pixels 345,600  2,073,600  5,184,000 

Apple first introduced the concept of high resolution, retina display on the iPhone 4 in 2010, followed by the 3rd generation iPad last year and now the Macbook. All of these devices have a pixel density approaching that of the human eye.

Now imagine these displays used in medical imaging applications like PACS, MRI’s or CT scans. Think about these images and how much more accurate, detailed, and precise they would appear. Would this level of clarity assist radiologists and doctor’s to be more decisive and conclusive with their diagnoses resulting in a more precise and expeditious diagnosis, treatment and cure? The potential is exponential.

Also imagine these displays on medical devices like physiological monitors such as EKG’s, blood pressure, respiration, and pulse oximetry monitors. Would nurses be more able to provide a better level of care by reducing eye fatigue and eyestrain while increasing their accuracy and efficiency? Visual clarity automatically enhances one’s mental clarity thereby reducing ambiguity and doubt making the arduous work of a nurse more fluid and less questionable.

Is the race on? Which is going to be the first medical application to make full use of the Macbook retina display? And which medical device manufacturer will start shipping retina displays? Right now there are more questions than answers but I think that will be changing very soon. 

No apps were harmed in the creation of this blog

by Benjamin King 10. November 2011 12:30

Welcome to my first blog article, which happens to be written on my new iPhone 4S without a keyboard thanks to the help of Siri and speech to text. No desktop or laptop computer was used in the creation of this article and no apps were harmed in the process. Now for my top five favorite new features:

1. Siri is your new personal digital assistant. Siri is so much more than a speech to text recognition engine. It is the next generation. It is the next dimension. I remember when I got my first smartphone, the Palm Treo, and how complex it was to create something as simple as a new calendar event. I literally wished I could just talk to my phone and tell it to create a new event for tomorrow at 5 PM. Now, Siri does just that.


2. Reminders.app never forget anything again. This is one of my favorite new apps! I once carried a folded sheet of paper and post-it notes in my pocket with all my reminders. Now this app takes it to the next level and will remind me of my task at a certain time or location. The reminders based on location are amazing. For example, I can ask Siri to remind me to take my lunch when I leave the house or when I get to work to call Bob. This is what makes Siri seem so lifelike.


3. iMessage, therefore I am. Apple is now getting into the text messaging game and making it ridiculously easy to use. No configuration required and it works on the iPod touch and iPad. iMessage supports delivery receipts and read receipts, if they are enabled, but the killer feature is group messaging. Also Siri will be happy to read your new text messages aloud and create new ones hands-free (you know where I'm going with this one).


4. Camera and photos. This is the beginning of the end for the point-and-shoot digital camera. The iPhone 4S rivals most digital cameras with its eight megapixels and take 1080p HD video. It will edit your photos and videos, as well as GPS tag and upload them to your favorite social network! What digital camera lets you do all that? RIP digital point-and-shoot you served us well.


5. Speed demon. Every new iPhone gets faster and faster and the iPhone 4S is no exception. It has the new dual core A5 processor, which Apple claims is "up to two times more power and up to seven times faster graphics". I definitely agree, all my apps load faster and feel much more responsive.


My Conclusion: I love my iPhone 4S. When I hear people complaining that the 4S isn't that much different from the iPhone 4, ask them if they can "write" an entire blog article on their phone without using a keyboard? 

If You Build It, Will They Come?

by Benjamin King 15. December 2010 09:09

If you write it, will they read it?  If you sell it, will they buy it?  If you _____it, will they _____it?   Fill in your own blanks.   Subconsciously, these  "if" questions are the ones that are asked by anyone initializing any new undertaking or maybe just satisfying a curiosity.

Many people have asked me how Voalte got started.   Hmm… Are they contemplating a similar undertaking or are they just curious?  Who and why is someone asking me this question?  Well, for starters, I attend many technology-related events such as local developer meet-ups, barcamps (those not related to alcohol serving establishments) and conferences and at every possible opportunity I proudly and passionately speak about my company and what we are doing.  I am so passionate and enthusiastic, I always get asked the question, "how did Voalte get started?"  Technologically speaking, I can relate to my audience very well.  Techies tend to think alike and resonate very well when speaking technology, but when it comes to the flip side -  the business or entrepreneurial side - then the resonance levels dip drastically.  Why?  

It seems like most of the techies I meet all seem to have some great new idea for an application or service that they think might rock the world like a Google or Facebook.  Ok, Ok.  I have this idea now tell me again how Voalte went from idea to version 1.0?  If I develop this, will they… you know the rest.

Once upon a time in June 2008, I was attending Apple's Worldwide Developer Conference in San Francisco.  This was just after Apple had released the iPhone software developer’s kit (SDK) to allow native applications on the iPhone.  Everyone and their mother was at the conference trying to learn how to create the next BIG app for the iPhone.  By the way, it was the first time Apple's developer conference had ever sold out!  It was a techie gold rush.

One night while socializing with other iPhone developers, we literally bumped into a young entrepreneur named Trey Lauderdale (who unfortunately was not able to buy a conference ticket in time).  He very generously offered to buy us a drink in exchange for our time to listen to his idea,  I recall it being such a simple idea, the kind that makes you ask yourself, "why didn't I think of that?"  His idea -- sending critical hospital alarms, such as nurse call, code blue or patient monitoring alarms to the iPhone.  Right off the bat I got it.  The iPhone would be the perfect mobile platform for use in the healthcare industry.

After the conference ended, Trey and I kept in touch.  It helped that he was living in Miami and I was living in Fort Lauderdale at the time.  A month had passed and Trey asked me to create a "real" simple demo application that he could present to some hospital CIOs.  I spent about two weekends creating the most basic iPhone app that when launched would pop-up a nurse call and a code blue alarm.  With that demo in hand, Trey approached several CIOs and was told right then and there, "if you build it, we will buy it."  From that first simple little app and positive reassurance from potential future customers, we had our green light.  It was all systems go.  The rest is history.  

I'd like to pass on some advice to new and upcoming entrepreneurs who think they have the next great idea.  First and foremost - keep your idea simple - simple to comprehend, that is.  Do not lose yourself or your audience in the stratosphere with an idea that is not understood or too complicated. Remember to resonate.  Because once you get going, your idea will take on a life of its own and, believe me, it will get more intense and complicated.  More so than you can ever imagine.  Second, sell your idea before you build it.  I know this is the hardest part of the equation for an engineer to understand - trust me - if you don't sell your potential customers now then they will not buy it when it is built.  Thirdly, do not try to do this all by yourself.  Impossible.  Get some partners in crime that compliment your skills and have the same energy and passion that you do.  Lastly, as Rob Campbell, our fearless CEO, constantly reminds us; this is not a sprint but a marathon.  We are doing so much more than just building an app.  We are saving lives, improving healthcare communication, building a culture and helping to change the world. 

Mouse Magic Meets Voalté

by Benjamin King 1. July 2010 08:37

As if I didn’t have enough to do when my CEO walks in and says he wants me to attend a people management course at the Disney Institute. 

I would say that I am a pretty likeable person and I get along with ninety nine per cent of the people I meet, so why do I need people management training?  Well how about saving time, saving money, sustaining good employees and developing a strong corporate culture to name a few.  After all, a few days at Disney can’t be all bad and they do employ a lot of people and they do have a pretty successful track record.  Why not?

After the training, and filled with newfound knowledge, I decided to put my new skills to work at Barcamp Sarasota.   With my Disney training manual close at hand, I proceeded to emulate the giant mouse. Barcamp is a type of 21st century ”unconference”, a facilitated user-driven unstructured conference usually based on a technological theme. When you arrive you can sign up to give a presentation or just meet other like-minded individuals. 

 The Disney approach to people management focuses on four main themes -recruitment, training, communication and care.  Now this is where Disney weaves it’s magic.  Their attack strategy (so to speak) is to create an overall mood by way of incorporating beautiful visuals and audio into their training and literally everything else they do. They attack your senses and arouse your emotions.  You are rendered helpless.   They create a magical formula that leaves an everlasting impression on anyone who enters their domain.  This was now going to be my new approach to organizing Barcamps, hiring employees and helping to develop an enviable corporate culture.

My first plan of action was to create a buzz, not just interest, but hype and buzz and excitement that Voalté, a prominent, young, local start up, was an organizing sponsor of Barcamp Sarasota.  The word started to spread that we were coming and also seeking to recruit a couple of summer interns for software testing. 

At Barcamp Sarasota I gave a presentation about Voalté, who we are, what we do and what our goals are.  Borrowing on Disney’s captivating audio and visual approach I included pictures, videos, and music to enhance my presentation and motivate my audience.  Before the presentation began I put up an image of the four co-founders of Voalte wearing our signature black and pink scrubs.  In the background the Pink Panther theme was playing. The mood was set.

After my presentation I was approached by many young hopefuls who all wanted to intern at Voalté .  Because of the overwhelming response, I now had to set up a round of interviews.  Once again, I had the opportunity to focus on my new people management skills.

The first item on my agenda was to prepare a plan of action prior to the interviews.

The plan included having the interns being interviewed individually by the four co-founders whose photos they had already seen at Barcamp.  Next, I prepared the conference room where the interviews were going to take place.  I wanted their first impression of Voalté to be stellar.  The conference room also included images of our advertising campaigns and trade shows.  A little attention to detail helps set the mood.

Fortunately we were able to select two interns from our pool of applicants. 

Voalté is a mobile development shop where we create iPhone and BlackBerry applications.   Now our two interns had to be trained on how to use our computer systems, how to use our development tools and how to build our software.  Training and communication was key.

Everyday became a new learning experience for our interns.  Daily they met with me for 30 minutes to review work they had completed and to receive their marching orders for the day.  They were also included in the daily developer briefings (scrum) and by the second day they were giving the other team members an update on their progress.  By the end of their first week not only did they manage to find a couple of bugs but they also completed their first test report and summary.  Everyone was very impressed.  As a reward for their hard work and efforts I took them out for lunch at the end of their first week.  Even Disney agrees that by celebrating success you create an environment of success.

When you break down and analyze the Disney “dynamic” it literally all boils down to common sense and simplicity. Disney did an amazing job of articulating and presenting their blueprint to us. It consistently works for Disney and many Fortune 500 companies. It’s really very simple if you follow the blueprint and implement the concepts.  You’ll be amazed.

Is Erlang Right for Healthcare Communication?

by Benjamin King 1. April 2010 12:07


Erlang

Last week I attended the second annual Erlang Factory 2010 conference in San Francisco.  Erlang, is a programming language and runtime environment (which means it has it's own virtual machine, unlike most languages).  For example you would develop your application using the Erlang programming language and then run it in an Erlang virtual machine on top of your operating system.  This added level of abstraction allows your Erlang application to run on any system that can support the Erlang virtual machine.  During that conference I delivered a 10-minute presentation on Erlang in Healthcare, how the Voalté server is powered by this new technology and what it can offer other developers in the healthcare community.

Who is using Erlang in Healthcare? As far as I know, Voalté is the only company using Erlang in production software within the healthcare market.  Please comment if you know of any other companies.  We would love the opportunity to share best practices and discuss how to better evangelize Erlang in the healthcare space.

Why are we using Erlang? Ericsson, the European telecommunication supplier, developed Erlang in their research labs during the mid-1980's for the following reasons:

Concurrency - Erlang's main strength lies within its support for multi-core CPU's.  Erlang is designed around the idea of extremely lightweight "processes" that communicate via asynchronous message passing,,  thus avoiding the complexity and performance impact of threads and memory locks.

Distribution - Erlang was designed to be run in a distributed environment with each Erlang virtual machine referred to as a node.  A network of these nodes on different machines can communicate as if they were all on the same computer.  This built-in distribution makes it very easy to create a cluster of computers running your application.

Fault-tolerance - Erlang will continue to operate if a node goes down or becomes unreachable.  Erlang processes can be linked to each other so if one fails the other process is immediately notified and could restart the crashed process.  Therefore crashes in an Erlang application are not the end of the world because they can restart immediately in a manner that is transparent to the end user.

Robustness – Erlang’s error detection can be used to fail-over to other nodes and Erlang's use of pattern matching allows for a "catch all."  This makes designing and prototyping new features easier because you don't have to specify, in advance what types of objects you can receive.  

Soft real-time – Erlang’s response times are in the order of milliseconds, which is excellent for failover support. 

Hot-code swapping – Erlang code can be changed without stopping a system, something no other runtime system has built-in.  This is one of the coolest features, that can permit users to update code without stopping their application and thus enable continuation of an application.

Healthcare, like telecommunications has the same general system requirements, which are distributed high-availability systems.  Point of Care workers need to receive and respond to realtime data from nurse call, patient monitoring and smart medical devices.  Erlang was designed and created from the ground up to make creating these types of distributed high-availability systems practical.  Voalté embraced Erlang's sophisticated functionality, which allowed us to produce a product that was ready to pilot in an impressive time frame of only six months.  In addition, the hot-code swapping aspect has allowed us to update our server while causing minimal system interruption to the end users.

It's an exciting time to be apart of the Erlang community.  Bjarne Däcker, one of the fathers of Erlang, presented the growth curve for Erlang and it’s starting to look like a hockey stick curve (hopefully just like Voalté sales!).  Erlang is being adopted by many leading companies such as Facebook for their chat system, Yahoo, E*trade, and Chrysler, just to name a few.  At the Erlang Factory conference I had the opportunity to meet many people using Erlang in their applications including the founders of the Erlang language.  It was great to get their feedback on Voalté and to hear their stories about creating this great platform that is at the heart of the Voalté Server.

Voalté Provides iPhone audio to Open Source

by Benjamin King 11. February 2010 19:13

Our First Open Source Project

The project is an audio driver that connects the iPhone audio system, using the Audio Unit API, to the PJSIP framework (also open-source). It's primary propose is to provide Voice over Internet Protocol (VoIP) using the PJSIP framework on the Apple iPhone platform.

The iPhone SDK has a couple of audio API's. The choice of Audio Units gives very low-latency audio input/output in near-real-time. Audio Units are the lowest audio layer available in the iPhone SDK. In addition to this, Apple has supplied the Voice Processing I/O Audio Unit which provides acoustic echo cancellation! We take for granted the fact that we don't hear ourselves (an echo) when talking on speakerphone.

In the iPhone, the speaker (used in speakerphone mode) and the microphone are in very close proximity to each other. (They're both on the bottom of the device.) This can easily cause feedback, or an echo, when the microphone picks up sound coming out of the speaker. Consequently that sound gets sent back to the caller who now hears an echo of his/her voice. The echo is so bad that some VoIP software providers opt not to support speakerphone on the iPhone device.

Another major component of this echo cancellation capability is the ability to remove system sounds or alerts. For example when you are on a phone call and the device plays an alert tone that may or may not have come from your application. The voice processing unit removes the alert tone from the audio input, and the person you are talking to does not hear it at all. These noises are normally impossible to dampen, as they originate outside the pjsip audio stack.

By open-sourcing, we hope to promote VoIP on the iPhone platform, and a broader collaboration from both the iPhone and PJSIP communities. We encourage others to contribute by providing ideas, solutions and improvements by way of bug fixes, performance improvements, added features and thorough testing beyond our own application environment. Because of the BSD-license any iPhone developer will be able to use the work, including commercial apps. We hope this equates to more interest in the project, and more active development from a larger audience. Ultimately, we want to encourage open collaboration and provide the best user experience for VoIP on the iPhone platform.

http://code.google.com/p/pjsip-iphone-audio-driver/


 

Our Blog. Our Talk.

Welcome to the Voalté Blog! Check back here for news and updates and cool things going on in the Voalte world.

Articles

Tag cloud